Is Pre-hospital Coagulation Management in Trauma Feasible?

Is Pre-hospital Coagulation Management in Trauma Feasible?

Coagulation management remains a formidable challenge in severely bleeding trauma patients. A strong rationale suggests starting treatment of trauma-induced coagulopathy in the pre-hospital phase. The burden of trauma is... read more

Reducing Emergency Department Length of Stay

Reducing Emergency Department Length of Stay

An interdisciplinary team of front-line physicians, nurses, medical assistants, and executives assembled and used value stream mapping to assess the entire ED care process, from patient arrival to admission or discharge.... read more

Teaching the Principles of Pediatric Critical Care to Non-Intensivists in Resource Limited Settings

Teaching the Principles of Pediatric Critical Care to Non-Intensivists in Resource Limited Settings

It is a dismal reality of global health that the vast majority of critically ill or injured children are found in regions of the world least equipped to care for them. Most of these severely ill or injured children are cared... read more

The Effects of Family Functioning on the Development of Posttraumatic Stress in Children and Their Parents Following Admission to the PICU

The Effects of Family Functioning on the Development of Posttraumatic Stress in Children and Their Parents Following Admission to the PICU

Both children and parents have alarmingly high rates of acute stress and posttraumatic stress following the child's PICU admission. Although family function did not emerge as a predictor in this study, further understanding... read more

European Guideline on Managing Post-traumatic Bleeding: 5th Edition

European Guideline on Managing Post-traumatic Bleeding: 5th Edition

An updated guideline on the management of significant bleeding and coagulopathy following major trauma has been released by the pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma. The document,... read more

Ketamine In Acute and Chronic Pain Management

Ketamine In Acute and Chronic Pain Management

The view of chronic pain as a symptom of a disease, rather than a disease state itself, has contributed to neglect in treating this condition. Although it is generally acknowledged that patients with chronic pain use significantly... read more

Safety of Early Tracheostomy in Trauma Patients After Anterior Cervical Fusion

Safety of Early Tracheostomy in Trauma Patients After Anterior Cervical Fusion

Cervical spine injuries (CSIs) can have major effects on the respiratory system and carry a high incidence of pulmonary complications. Respiratory failure can be due to spinal cord injuries, concomitant facial fractures or... read more

Indications and Outcomes of Extracorporeal Life Support in Trauma Patients

Indications and Outcomes of Extracorporeal Life Support in Trauma Patients

Data from the largest registry of critically ill trauma patients receiving extracorporeal life support (ECLS) demonstrates reasonable survival. With growing experience and improved safety profile, trauma should not be considered... read more

Extravascular Lung Water as a Target for Intensive Care

Extravascular Lung Water as a Target for Intensive Care

Extravascular lung water (EVLW) remains a useful guide for monitoring pulmonary edema (PO) and vascular permeability in sepsis, acute respiratory distress syndrome (ARDS), and heart failure. In addition, EVLW has a prognostic... read more

Management of Pediatric Severe Traumatic Brain Injury

Management of Pediatric Severe Traumatic Brain Injury

This article provides an algorithm of clinical practice for the bedside practitioner based on the available evidence, treatment protocols described in the articles included in the 2019 guidelines, and consensus that reflects... read more

Trauma Electives in South Africa Provide Valuable Training for International Surgeons

Trauma Electives in South Africa Provide Valuable Training for International Surgeons

Trauma training and trauma preparedness are increasingly areas of concern worldwide. Formal military conflicts over the past 2 decades have ensured that most military surgeons have been exposed to a significant volume of... read more

Intrathoracic Pressure Regulation Therapy Applied to Ventilated Patients for Treatment of Compromised Cerebral Perfusion from Brain Injury

Intrathoracic Pressure Regulation Therapy Applied to Ventilated Patients for Treatment of Compromised Cerebral Perfusion from Brain Injury

These data support the notion that active intrathoracic pressure regulation, in this limited evaluation, can successfully augment cerebral perfusion by lowering intracranial pressure and increasing mean arterial pressure... read more

Tranexamic Acid For Isolated Penetrating Head Trauma

Tranexamic Acid For Isolated Penetrating Head Trauma

An aeromedical crew was dispatched to a local emergency department to transport a fourteen year-old female with self-inflicted gunshot wound to the head to a tertiary pediatric trauma hospital. The patient was previously... read more

ECMO in the Critical Trauma Patient

ECMO in the Critical Trauma Patient

Growing evidence suggests the potential use of Extracorporeal membrane oxygenation (ECMO) for the treatment of refractory respiratory failure in adults, but the clinical benefit in polytraumatic patients is not clear. The... read more

Selected Imaging Controversies in ED Trauma

Selected Imaging Controversies in ED Trauma

Traumatic injuries are amongst the most common presentations for all emergency departments (ED). In 2010, there were over 1 million patients in Canada who visited the ED for trauma, result in an cost of almost 9 billion dollars.... read more

Why Do Bleeding Trauma Patients Die?

Why Do Bleeding Trauma Patients Die?

It is important that we recognize that we have seen a reduction in the number of deaths from trauma. That's a great thing of course, but we should not be complacent. It's also worth looking at where and how patients die.... read more

Many Doctors Have Distorted Perceptions of the Value of Medical Tests

Many Doctors Have Distorted Perceptions of the Value of Medical Tests

In 2014, the Canadian Task Force on Preventive Health Care recommended against the prostate-specific antigen (PSA) test used to screen for prostate cancer in healthy men, concluding that it results in substantial harms via... read more